Mass Casualties

The Massachusetts attempt at universal health coverage (AKA RomneyCare) has, at least according to some, achieved the goal with almost 100% of Mass citizens (and even non-citizens) obtaining health insurance.

But just barely 5 years into the program already they are trying to figure out how to reduce the cost of health care in an attempt to make health insurance more affordable.

Stateline reports the following.

Massachusetts spends 40 percent of its budget on health care and median-income families are expected to spend one-third of their paychecks on health care by 2016.

That's going to leave a mark.

So how do they propose to address this issue?

It’s important to move to a more cost-effective payment model, he says, but the savings won’t get passed along to consumers unless the state restrains the fees doctors and hospitals are able to negotiate. “Everyone has a big stake in making this work,” Berenson adds. “If it doesn’t, the whole thing could fall apart.”

So simple. Just pay health care providers less money.

Yeah, that will work.

Just like it is working in Wisconsin. Workers there have no problem taking one for the team since means saving taxpayer money.

About Those Waivers

After penning this post about the latest Obamacrap waiver for states, it occurred to me this is not really a gift.

States may be given a pass from participating in Obamacrap if they come up with a plan that meets the same criteria for coverage and affordability.

But what is the target for defining affordable?

In spite of what has been promised, there is nothing in Obamacrap that will reduce the cost of health care, or health insurance. So if the states set up a plan and the premiums increase over current levels (which they will), what is the repercussion to the states?

Question number two is this.

Even if all 57 states are granted a waiver from Obamacrap, does that mean all the new taxes contained in the bill are still in play?

My guess would be yes.

MRI in Your Pocket

Need a biopsy? Don't want to wait on results? There's an app for that!

A portable scanner built at Massachusetts General Hospital allows doctors to get biopsy results in an hour.

First the physician collects patient cell samples, which are miniscule enough to be aspirated with a fine needle from multiple sites of a suspect tumor, increasing the accuracy of the results. Then the physician puts the cells into the scanner and connects it to a smartphone, of all things. The device looks for signs of nine proteins specific to cancer cells in order make its diagnosis. With a custom app, the doctor can read the results from the machine within the hour.

Is that cool or what?

A word about Morgellon's Disease

How would you like to awaken one morning to find yourself with these symptoms:

"crawling, biting and stinging sensations; granules, threads or black speck-like materials on or beneath the skin; and/or skin lesions (e.g., rashes or sores) and some sufferers also report systemic manifestations such as fatigue, mental confusion, short term memory loss, joint pain, and changes in vision."

Welcome to the (painful, frustrating) world of Morgellons.

Recently, a dear friend contracted this dread disease, and began her own journey towards healing. It has not been an easy path: for one thing, most of the physicians she's consulted continue to treat this as "all in her mind." Which would be funny, were it not for the very real, obvious symptoms. My friend has agreed to share her story with us, both to enlighten us about the illness, and in hopes of connecting with others who may be suffering from it and (hopefully) resources that have thus far been elusive.

Here's her story:

There is an illness that is emerging in every state of the US and in many other countries. It is very serious and needs to be acknowledged and dealt with by physicians and health care systems. It is called Morgellons. The initial presentation of the illness is often what the CDC (Centers for Disease Control) calls "unidentified dermopathy." This would be skin eruptions, lesions, itchiness, and a sense of something crawling under the skin. American physicians misdiagnose the illness because these symptoms compare to those of "delusional parasitosis," and offer patients antipsychotics as the only treatment. However, if the patients' skin were simply examined with a hand held microscope, physicians would observe the chief diagnostic feature of Morgellons: fibers in the skin of the patients.

In addition to the humiliation and anguish of being diagnosed as psychotic, patients do not have the benefit of a physician who looks beyond the initial presentation of the illness. This is devastating because the illness becomes systemic and can affect multiple organ systems. Few patients get treatment and many become debilitated. Many patients seek out assistance from dozens of doctors, to no avail. Some commit suicide. I have had this illness for five months and have gone through many expensive tests and scans because my doctors are not willing to look at the possibility that the Morgellons has caused: elevated calcium, daily diarrhea, rapid unexplained weight loss, skin eruptions, fungus-like "spores" exuding from my skin.

Unfortunately, the major source of information about Morgellons is the internet. Mixed in with real observations by a few researchers, one finds controversy, conspiracy theory etc. etc. However there are a few sites that are useful for gaining reliable information:

■ Centers for Disease Control

■ Morgellons

■ Morgellons Research

To name a few. One of the best resources I've found is Ginger Savely; Ginger's a Nurse Practitioner who has seen many Morgellons patients and who has done research with 122 subjects. Another researcher is Dr. Kilani, of Clongen Labs. He has done preliminary microscopic research, looking at the organism believed to be causing Morgellons in patients. He has a Ph.D. in infectious diseases from UC Berkely and postdoctoral training at Stanford Univerity Medical School.

I have been searching for help and answers for five months. No physician in my area has any information about this illness. If ANYONE out there knows of credible treatment providers for Morgellons, especially in the midwest, please let me know. If you do a little research for yourself, you will understand the depth of my plea here!

We'd welcome any feedback you might have in the comments.

Bronx OB's Given the Boot

According to the WSJ online, obstetricians in New York will not be able to renew medical malpractice policies issued by Medical Liability Mutual Insurance Company.

The hospital delivers about 2,700 babies a year. Many of the patients are teenagers or have diabetes, high blood pressure or other medical problems.

The letter cited a "method of practice" among the doctors that made them "an unreasonable burden" to other policyholders.

Wonder how many of their patients are on Medicaid?

Gender Bender

Under a new law, young women will pay more for car insurance, men will pay more for life insurance, and male retirees will receive lower monthly benefits. All this is because of government intervention in the free market and flies in the face of risk management . . . something the government knows nothing about.

The European Court of Justice has ruled sex based pricing is discriminatory and has banned this years old practice.

The judgment ignores the fact that taking a person's gender into account, where relevant to the risk, enables men and women alike to get a more accurate price for their insurance."

Please tell me why this is good for consumers?

Adrian Webb of esure said the prohibitively high cost of car insurance for young men has previously helped discourage them from buying high performance vehicles, thus reducing the risk to themselves and others.

"If young men's premiums are artificially reduced, this could lead to more opting to choose more powerful vehicles," he said. "It is particularly alarming given that the head of the Association of Police Officers in the UK in 2005 noted that the biggest killer of young women in Britain is their boyfriend's and male friends' driving."

The law is an ass.

Car insurance for women could rise as much as 25%, annuity pensions for men may be reduced by 8% (lower monthly payout) and life insurance premiums for women may rise by 25%.

But this is in Europe, not here.

At least not yet . . .

Grand Rounds us up!

Dr Charles presents this week's collection of interesting medblog posts, in handy list form for easy navigation.